Thursday, January 23, 2014

Fentanyl Transdermal Patch Application Sites

English: 2D structure of fentanyl
English: 2D structure of fentanyl (Photo credit: Wikipedia)
We know that fentanyl patches should be applied to dry, noninflamed, non-irradiated, hairless skin. Body hair may be trimmed but not shaved. Be sure to press the patch firmly in place for 60 seconds or more. If problems with adherence, use Tegaderm or Micropore.

Fact or Fiction From Medscape:

Q: Is it true that fentanyl patches infuse more quickly in patients with very little subcutaneous fat?

A: No. The amount of fentanyl absorbed is proportional to the surface area of the patch. The absorption rate does not vary to any clinically significant extent between the chest, abdomen, and thigh.[5] Fentanyl is released from the patch into top layers of the skin (stratum corneum and epidermis), and it accumulates within these layers to form a depot. The drug is released slowly into the systemic circulation via small blood vessels within the dermis. Fat tissue should not impair release, as the drug is released directly from the skin into the blood supply.[2,5]

Furthermore, fentanyl exhibits wide tissue distribution to the lungs, kidneys, heart, spleen, brain, muscles, and body fat -- indicating a high extravascular volume of distribution (3-8 L/kg). It takes about 6 days to reach steady-state plasma concentrations after initiating fentanyl patch therapy.[5]

  • Muijsers BBR, Wagstaff AJ. Transdermal fentanyl: an updated review of its pharmacological properties and therapeutic efficacy in chronic cancer pain control. Drugs. 2001;61:2289-2307. Abstract
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Learn Something New qD: Methadone and Verapamil are Structurally Similar

English: Synthesis of methadone Deutsch: Synth...
English: Synthesis of methadone Deutsch: Synthese von Methadon (Photo credit: Wikipedia)
structural formula of Verapamil
structural formula of Verapamil (Photo credit: Wikipedia)
In a new series at OncoPRN, look for unique facts in the world of medications, oncology and palliative care

From Medscape:

"Methadone appears to have a molecular structure similar to that of verapamil and may exhibit similar cardiac properties, such as calcium channel blockade.[10] One study demonstrated that methadone, unlike morphine, significantly lowered heart rate in rats (p<0 .05="" span="">[10]

10 Seyler DE, Borowitz JL, Maickel RP. Calcium channel blockade by certain opioids. Fundam Appl Toxicol 1983;3:536-42.

The potential of methadone to cause adverse effects similar to verapamil must be taken under consideration clinically in any patient taking methadone or is to start methadone.
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Thursday, January 16, 2014

No More Needles? 7 Ways Scientists are Attempting to Move Beyond Shots (TED Blog)

No more needles? 7 ways scientists are attempting to move beyond shots | TED Blog:

A shot through a puff of air

"In 2012, Jack You of Seoul National University unveiled a device that delivers drugs through a laser pulse. The pulse lasts 250 millionths of a second and, through a series of reactions described on, creates a narrow jet of medicine that is just larger than the width of a human hair. “The impacting jet pressure is higher than the skin tensile strength and thus causes the jet to smoothly penetrate into the targeted depth underneath the skin,” explains Yoh. This device is intended to get medicine to the epidermal level."

Full article link: click here

TED - ideas worth sharing!

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About Onco-PRN

Welcome and thanks for visiting Onco-P.R.N. - The oncology website with a focus on all things oncology pharmacy/pain/palliative care-related. It is intended to be an information resource for those pharmacist and relevant health care professionals involved in whatever fashion with cancer and palliative care. Stay tuned for the latest and greatest links and information with respect to: oncology medications, continuing education, pharmaceutical care initiatives, pain and symptom control, supportive care topics, and whatever else that might fit into the theme.

*Note: This website is not affiliated with Alberta Health Services (AHS) or CAPhO and the opinions expressed herewithin are that of the author(s).

Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia:

Journal of Palliative Medicine - Table of Contents

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